2. NEWS

In letters sent to countries by email on 15 December, the Global Fund provided countries with information on their allocations for 2017-2019. The letters include an indicative split for the three diseases – HIV, TB, and malaria. The Fund encourages programs to support resilient and sustainable systems for health; the funds for such programs will need to be carved out of the allocations for the diseases.

3. NEWS

The Fund has identified 14 initiatives it seeks to enhance the effectiveness of by implementing its Prioritized Action Plan, or PAP. This article explains the PAP, what it monitors and assesses, and elaborates upon the purpose behind it.

4. NEWS

Whether the Secretariat should have a presence in high-risk countries was one of the items discussed at the recent Board meeting in Montreux, Switzerland. This article provides a summary of a paper on the current business model prepared for the meeting.

5. NEWS

Although national supply chain inefficiencies are resulting in a number of significant issues affecting Global Fund operations in-country, the Fund is aware of the problem and is working to resolve the issues. Such issues range from stock-outs and expirations of drugs and supplies, and to overstocking.

6. NEWS

In June 2016, the Strategy Committee determined the process to be used to make qualitative adjustments to the initial allocations derived from the application of the disease burden/income level formula. An article in GFO 301 described the two stages of the process: epidemiological considerations and holistic adjustment. In this article, we provide information on the parameters being used to make the adjustments.

7. NEWS

In February 2016, a second window of Regional Concept Notes, or RCNs, were submitted to the Global Fund. As a result of this process, ICASO and the International HIV/AIDS Alliance conducted six case studies of the respective RCN development. This article highlights the report findings.

8. NEWS and ANALYSIS

This article provides information about how the research of the clinical protocols for opioid substitution therapy supported by the Global Fund, contributes towards sustainability of harm reduction programs in Eastern Europe and Central Asia.

9. NEWS and ANALYSIS

Work carried out by Dr. Abdhalah Ziraba of the African Population and Health Research Center, reveals country actions through Implementation Through Partnership-ITP, or the implementation of country roadmaps, are proving to be successful in addressing absorption bottlenecks and such efforts should be sustained and institutionalized in countries facing significant absorption challenges.

11. NEWS and ANALYSIS

In its final report released last week, the Equitable Access Initiative recommended that a multi-criteria framework be used instead of World Bank income level classifications in policies affecting eligibility for funding and the allocation of resources. The recommendations apply to all donors, not just the Global Fund.

Global Fund releases information on the 2017-2019 allocations

After informing eligible countries of their 2017-2019 allocations (see GFO article in this issue), the Secretariat posted a spreadsheet on its website showing the full list of allocations.

The spreadsheet shows the total allocation for each country, as well as the indicative amount for each disease (i.e. the program split). In its allocation letters, the Secretariat told countries that it could propose modifications to the split. It also encouraged countries to include in their funding requests for cross-cutting interventions to support resilient and sustainable systems for health (RSSH). The program split did not show any amounts for RSSH. Instead, funding for the RSSH interventions has to come from the amounts shown in the allocation letters for HIV, TB and malaria.

There was $10.3 million available for the country allocations. See Table 1 for details on how this amount was calculated.

Table1: Calculation of amount available for allocations to countries in 2017-2019 ($US)

Item

Balance

5th replenishment results as announced 2016-09-17

$12.9 b

Minusadjustment of $0.89 billion to reflect spot rates as at 2016-09-22

$12.02 b

Minusadjustment of $1.12 billion for technical assistance and other donor conditions

This compares to the $14.82 billion that was available for the 2014-2016 allocations. However, one has to be cautious when comparing the two allocation periods. The 2014-2016 allocations constituted a transition from the rounds-based system. The $14.82 billion included $5.5 billion in existing funds unspent as of the beginning of the allocation period. The 2017-2019 allocations included only $1.1 billion in unused funds from the earlier allocation period. The other major difference is that for most countries the allocations for 2014-2016 ended up having to cover a four-year period, whereas the 2017-2019 allocations cover only three years.

Table 2 shows how the 2017-2019 allocations broke out by disease.

Table 2: 2017-2019 allocations, by disease

Disease

Allocation amount ($ billion)

% of total

HIV

$5.1 b

49.5%

Malaria

$3.3 b

32.0%

TB

$1.9 b

18.4%

Total

$10.3 b

100.0%

Discrepancies in totals due to rounding.

This is very close to the ideal portfolio split determined by the Board (HIV 50%; malaria 32%; TB 18%). Note, however, that the program splits provided to countries were only indicative. Countries may request a change in their split. This could affect the overall portfolio split.

Please note: The totals for tables 2, 3, and 4 should be identical – i.e. $10.3 billion ­– but there are some minor differences. Some, but not all, of the discrepancies are due to rounding. In the time available to prepare this article, we were not able to determine the explanations for the other discrepancies. We suggest, therefore, that the reader (a) consider the amounts in this article to be approximate and (b) that the reader consult the Fund’s spreadsheet for the official figures. Part of the problem is that the Fund showed some allocations in US dollars and others in euros, and did not attempt to convert the euros into dollars. This made it difficult to add allocations to arrive at totals per disease and per region. On the advice of the Secretariat, we used an exchange rate of 1.12 dollars to the euro. This was the spot rate in effect on 22 September 2016, just after the end of the replenishment conference.

In Table 5, we provide a list of the top 10 allocations, as well a comparison with what these countries received for 2014-2016. We caution against drawing too many conclusions from the comparison, for reasons outlined above. Table 6 shows the list of bottom 10 allocations.

Table 5: Top 10 allocations, 2017-2019, showing the 2014-2016 allocation for each country

Rank

Country

Global Fund Region

2017-2019 allocation

($ billion)

2014-2016 allocation ($ billion)

1

Nigeria

HI Africa 1

$660,686,133

$1,137,314,849

2

Tanzania

HI Africa 2

$579,595,776

$632,547,564

3

DRC

HI Africa 1

$526,986,425

$701,418,878

4

Mozambique

HI Africa 2

$502,881,708

$450,276,363

5

India

HI Asia

$500,000,000

$850,000,000,

6

Zimbabwe

HI Africa 2

$483,980,512

$477,653,142

7

Uganda

HI Africa 2

$465,057,044

$420,990,516

8

Malawi

SE Africa

$450,475,140

$574,342,956

9

Ethiopia

HI Africa 2

$375,608,887

$591,183,361

10

Kenya

HI Africa 2

$355,631,851

$495,374,013

Table 6: Bottom 10 allocations, 2017-2019, showing the 2014-2016 allocation for each country

Rank

Country

Global Fund Region

2017-2019 allocation

($ billion)

2014-2016 allocation ($ billion)

1

Montenegro

EECA

$623,771

$ NIL

2

Serbia

EECA

$1,230,153

$ NIL

3

Gabon

Central Africa

$1,397,245

$5,336,611

4

Albania

EECA

$1,638,134

$6,006,282

5

Belize

LAC

$1,916,278

$4,504,323

6

Egypt

MENA

$2,058,336

$18,095,158

7

Costa Rica

LAC

$2,120,098

$4,883,405

8

Algeria

MENA

$2,312,936

$6,533,577

9

Mauritius

S-E Asia

$2,487,917

$5,128,597

10

Panama

LAC

$2,685,892

$7,812,375

In tables 5 and 6, the source of the amounts from 2014-2016 is the allocation database in the Aidspan Portal Workbench (accessible from the Aidspan home page).

In a news release, the Global Fund said that country programs receiving increases from their 2014-2016 funding levels have allocations on average 15% higher than current and projected levels of spending. “More funding is directed towards country programs with severe and extreme burdens of HIV, TB and malaria, towards sub-Saharan Africa, towards countries with high HIV infection rates in women and girls, countries with a high burden of multi-drug-resistant tuberculosis and to the top 15 high burden malaria countries,” the Fund said.